“I support the Four Pillars Strategy unequivocally. Mayor Philip Owen and City staff had the foresight to look to Switzerland in the 1990s. I hope this City Council will see the value in examining Portugal’s successful drug policy model in light of the overdose crisis our city continues to face.” – Councillor Melissa De Genova
October 22, 2019, Vancouver, B.C. – NPA City Councillor Melissa De Genova will be introducing a motion at today’s Vancouver City Council meeting urging Council to increase the resources available to City staff to research current drug policy amid the city’s ongoing opioid crisis. De Genova believes these increased resources are urgently needed, in part to move forward with a comprehensive review of the ongoing administration of the Four Pillars Drug Strategy, and in part to help find drug policy initiatives that are “new to Vancouver” that may help with the city’s overdose crisis.
“I support the Four Pillars Strategy unequivocally,” said De Genova. “Former Vancouver Mayor Philip Owen and City staff looked to Switzerland in the 1990s. I hope this City Council will see the value in examining Portugal’s successful drug policy model in light of the overdose crisis our city continues to face.”
In her motion, De Genova specifically points to the approach the Portugal model takes to decriminalization; that is, by imposing stiff penalties and jail time for drug traffickers whom the model defines as individuals found to be in possession of more than a ten-day personal drug supply. She says the integration of community in facilitating drug treatment to combat health epidemics, including HIV/AIDs and heroin use, put Portugal on the map in the 1980s and has proven to work well for that country. She feels Vancouver should be looking at that.
“The City of Vancouver currently has only one staff person tasked with drug policy research. By investing additional resources in this research, Vancouver can help to lead the way and protect vulnerable people in our city, many of whom are drug users. We need to demonstrate the City’s commitment to finding solutions and moving forward before we request funding from the senior levels of government. It is the only way we will achieve positive results,” said De Genova.
While noting that Vancouver faces some of the same issues Lisbon faced at the peak of its drug crisis, De Genova also acknowledges that there are some significant differences: “The Portugal Model is built on community support strategies Vancouver lacks, and our city does not have nearly enough treatment options. The solutions aren’t going to happen overnight, but we need to start looking at what we can do right now to move forward toward the positive results we want to see in the future.”
De Genova says she believes strongly that the specific actions outlined in her motion will not only complement the work of the Mayor’s Emergency Overdose Task Force, they will also help to reinvigorate the administration of the Four Pillars strategy in the city.
The text of Councillor De Genova’s motion is appended below (NOTE: the motion De Genova will introduce at Council this morning contains slightly amended wording reflecting suggestions by the City’s legal staff).
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MOTION: Four Pillars Drug Strategy Review and Additional Resources
Submitted by: Councillor Melissa De Genova
1. The Four Pillars Drug Strategy was introduced at Vancouver City Council in the 1990s by former City of Vancouver Mayor Philip Owen;
2. In 1998, Council approved “A Program of Strategic Actions for the Downtown Eastside” which included developing directions for the City to address substance misuse issues in the Downtown Eastside and the city;
3. Based on policy and research gathered from exploring models in European cities (Frankfurt, Geneva, Zurich) in the United Kingdom (Liverpool), Australia (Sydney) and U.S.A. (Portland, Oregon) on April 24, 2001, Council officially adopted a revised framework and policy recommendations “A Framework for action: A Four Pillar Approach to Vancouver’s Drug Problems”;
4. The Four Pillars Drug Strategy includes:
- Harm Reduction
5. Vancouver is world renowned for implementation of the Four Pillars Strategy and exploring new clinical trials, programs and approaches to address drug policy. Listed below are examples:
i) InSite opened September 21, 2003, in Vancouver’s Downtown Eastside and is the first supervised injection facility in North America. InSite is managed by Vancouver Coastal Health and over the years it has proved to be successful in several ways including reducing overdose fatalities, reducing the transmission of blood-born infections like HIV and Hepatitis C, increasing referral and connections with community and health programs;
The North American Opiate Medication Initiative (NAOMI) Study was approved by
Health Canada and funded by Canadian Institutes of health research. A Vancouver
clinical trial began with enrollment of 192 volunteers in 2005 and enrollment
concluded in 2007. The objective of this clinical trial was to test if
heroin-assisted therapy benefits people suffering from chronic opiate
addictions who have not benefited from other treatments. Clinical Trials were
also conducted in Montreal and Quebec City;
The Study to Assess Longer-term Opioid Medication Effectiveness (SALOME)
enrolled 202 volunteers for a clinical trial study beginning in 2011 with study
completion in 2016. SALOME endeavored to compare two medications-
diacetylmorphine (active ingredient in heroin) and hydromorphone;
6. The City of Vancouver and Mayor and Council over several terms and of different political affiliations have supported the Four Pillars Drug Strategy, updating actions in the strategy to address current and emerging community needs;
7. Overdose Prevention Sites and Drug Checking Services have expanded in Vancouver, providing clients at Insite and individuals using the Overdose Prevention Society Site and others the ability to test drugs for fentanyl and other substances. A Vancouver Coastal Health (VCH) media release in 2017 announced 4 locations and the Powell Street Getaway, offering a Fourier-Transform Infrared Spectrometer (FTIR), which can identify multiple ingredients in drugs;
8. April 14, 2016 the overdose crisis was declared a public health emergency in British Columbia and in the province over 3,600 people have lost their lives because of overdose;
9. December 20, 2018, a Special Council meeting was held for “Mayor’s Overdose Emergency Task Force -Recommendations for Immediate Action on the Overdose Crisis”. The following language carried in a Council amendment:
THAT Council direct staff to explore how all pillars of the Four Pillars Drug Strategy have been applied to the overdose crisis since the Provincial Medical Health Officer declared a public health emergency under the Public Health Act on April 14, 2016, and report back in Q3 of 2019;
10. In July 2019, Council approved a safe supply statement and recommended resolution for FCM to “call on the federal government to expand access to safe supply by proactively supporting all doctors, health authorities, provinces and all relevant professional colleges, including physicians and surgeons across Canada, to safely provide regulated opioids or other substances through a free and federally available Pharmacare program.” In September 2019, a resolution passed at FCM in support of initiatives to support and fast-track safe supply for municipalities;
11. Portugal has adopted an innovative model setting their system apart, including decriminalization of illicit drugs for users found carrying personal supply (for up to 10 days). The system has similar objectives to the Four Pillars Drug Strategy, like restorative justice, the “Commission for the Dissuasion of Drug Addiction” offers a different approach to enforcement. There is also access to a long-term safe supply for chronic opioid users, who can be connected to ongoing treatment and community support. The Portugal model is measured by data and success- including a significant reduction in overdose related deaths, the cost of incarceration, healthcare and property crime;
12. Although the City of Vancouver has expressed the need for increased treatment options, access to treatment is limited and waitlists can be ineffective and long for people facing addition.
THEREFORE BE IT RESOLVED
A. THAT, in the interest of moving forward with a comprehensive review of the ongoing administration of the Four Pillars Drug Strategy, Council direct staff to increase resources and the capacity of City staff to research drug policy. AND THAT the City Manager administer and organize staff and resources to increase the capacity of Arts, Culture and Community Services to research new drug policy to further achieve the goals of the Four Pillars Drug Strategy.
FURTHERMORE THAT this be implemented as soon as possible and no later than the 2021 City of Vancouver operating budget cycle.
B. AND FURTHERMORE, THAT Council direct staff to investigate and report back on the possibility of implementing “new to Vancouver initiatives”, that have proven to be successful in drug policy strategy approved by Portugal’s Assembly of the Republic. AND THAT any recommendations that may be brought forward, are in the spirit of The Four Pillars Drug Strategy and the Healthy City Strategy.